d.grondin , md frcpc director , migration health services international organization for migration

SEMINAR ON HEALTH AND MIGRATION

GUATEMALA CITY, October 2004

Report on the Seminar on Health & MigrationIOM’s International Dialogue on Migration

Geneva, 9-11 June 2004

D.GRONDIN, MD FRCPCDIRECTOR , MIGRATION HEALTH SERVICES

INTERNATIONAL ORGANIZATION FOR MIGRATION



Migration

Can’t be stopped

Don’t want to stop it

Migration will continue as long as economic imbalances and conflicts

exist.



… not just diseases

… addresses the state of physical, mental and social well-being of migrants and mobile populations

(IOM adapted from WHO’s definition of health)

Migration Health



Seminar on Health & MigrationGeneva, 9-11 June 2004

http://www.iom.int/en/know/idm/smh_200406.shtml



Session I: HEALTH & MIGRATION CHALLENGES

What is contemporary migration? Why should health be considered in the context of migration? What are the key challenges from a global perspective? What is at stake from both health and migration perspectives? Why should we care?

Commentator: IOM

• Migration perspective (Canada)• Health perspective (WHO)• Bridging health and migration (IOM)

Discussion health screening• effectiveness,

• ethics & discrimination

• applicability

• duality of focus:

migrant…. a threat

migrant…. a right to health



Session II: PUBLIC HEALTH & MIGRATION

A. Population mobility and public health What is being done to address the impact of population mobility on public health? Why do we

care? What lessons can we learn? What needs to be done?

Commentator: Switzerland

• Globalization of communicable diseases (Canada)

• The case of SARS: lessons learnt (Singapore)

Discussion health screening: Is it really effective?



Session II: PUBLIC HEALTH & MIGRATION

B. Managing global public health …Partnerships and developing bridging public health programsWhat benefits are there to include migrants into national and trans-national health schemes? Will this help the integration process? What are the public health issues of particular vulnerable people, such as the trafficked person.

Commentator: Norway

In situation of post-conflict • Investing in mental health in post-conflict rehabilitation (Cambodia) In situation of economic migration• Health as a tool for integration (Costa Rica) • US/Mexico tuberculosis b order health card: Bilateral TB referral & treatment initiative (CDC) • Public health and trafficking: When migration goes amok (Romania)

Discussion Policy dilemmas of managing health in situations of

irregular migration Cultural sensitivity of health care provision Investing in mental health….destigmatization



Session III: MIGRATION and HEALTH POLICIES

A. Investing in migration health What types of regulations exist at international and national level to address cross-borders health? What are their

purposes and how effective are they in addressing global public health? What are the options for policies to provide access to and improve health and social services for regular and irregular migrants? And what about deportation or voluntary return?

Commentator: Colombia • The International Health Regulations: Updates and perspectives (WHO)• National migration health policies: Shifting the paradigm from exclusion to inclusion (CDC)• Health and irregular migration (Australia) • Health and return migration (Jamaica)

Discussion Vulnerability conditions of the journey From policies of exclusion towards inclusion

….a right to access available health services Cultural sensitivity of health care provision Health: a pre-requisite to integration Co-responsibilities, complementarity



Session III: MIGRATION and HEALTH POLICIES

B. Migration of health care workersWhat are the issues related to the migration of health care workers? What are the country experiences in managing

health workforce migration? What are the different policy options available to countries in dealing with health workforce mobility?

Commentator: IOM • Global overview of migration of health care workers (WHO) • Using bilateral arrangements to manage migration of health care workers: The case of South Africa and the United Kingdom

(South African & United Kingdom ) • Using the Diaspora to strengthen health workforce capacity (Ghana)• Exporting health workers to overseas markets (India)

Discussion Negative phenomenon How can it be positive? Proposals for solutions

……use of the diaspora



Session IV: The WAY FORWARD

What is foreseen in the future? What progress might be feasible? Can we work towards healthier migrants and healthier societies? Commentator: WHO

• Population mobility and health crisis in conflict situations (Kuwait)• Possible solutions to manage migrants’ health: Thailand’s perspective (Thailand)• HIV/AIDS and population mobility – Where to go from here (Ethiopia)

Discussion Migrant stigmatization & prejudice

... proposals for solutions Priority areas

… bridging cultural gaps

… irregular migration

… elderly migrant



The way forward – where can we go from here?



Knowing is not enough; we must apply.

Willing is not enough; we must do. (Goethe)

d.grondin , md frcpc director , migration health services international organization for migration

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